doi: 10.5216/rpt.v48i4.

59036

ORIGINAL ARTICLE

ENTEROPARASITES, DEMOGRAPHIC PROFILE,

SOCIOECONOMIC STATUS AND EDUCATION LEVEL
IN THE RURAL POPULATION OF THE
RECÔNCAVO OF BAHIA, BRAZIL
Leonardo Bispo Reis, Raíssa da Silva Santos, Luiz Henrique Silva Mota,
Jamille Souza Almeida de Jesus, Juliana Mercês Oliveira e Oliveira, Raoni dos
Santos Andrade, Glauber Andrade dos Santos and Ana Lúcia Moreno Amor

ABSTRACT

Demographic and social studies, as well as economic and cultural factors in a community
are important regarding public health. This study identified demographic, socioeconomic and
cultural aspects correlated with intestinal parasites in the population of Santo Antônio de Jesus,
Bahia-Brazil, from July to October 2015. 53 semi-structured questionnaires were applied to
the rural population of the municipality with previous clarification on the purpose of the study.
There were questions related to the individual’s gender, family income and parental level of
education. Laboratory parasitological analyzes were performed to investigate enteroparasites
and produced the following results: 53.7% (n=58) were female; 62.8% (n=66) with monthly
family income lower or equal to the minimum wage and 48% (n=48) of adults with incomplete
basic education. The main enteroparasites found in this population were: Iodamoeba butschlii,
Entamoeba histolytica/Entamoeba dispar complex, Giardia intestinalis, Entamoeba coli
and Endolimax nana in addition to some geohelminths, such as hookworms and Enterobius
vermicularis. The profile visualized can be understood as a risk factor for the development of
certain parasitic infections that are intrinsically associated to the social and economic aspects
of vulnerable populations.

KEY WORDS: Teenager; adult; child; parasitic diseases.

INTRODUCTION

Intestinal parasitic diseases are a serious public health issue highly

prevalent in underdeveloped countries (Ludwig et al., 1999). The agents are
diverse and can cause a number of complications for the infected individuals.
Helminths and protozoa, for instance, can trigger asymptomatic, acute and
chronic diseases. According to Fernandes (2014), the helminthiases with

Centro de Ciências da Saúde, Universidade Federal do Recôncavo da Bahia - Santo Antônio de Jesus, Bahia, Brazil.

Corresponding author: Ana Lúcia Moreno Amor, Centro de Ciências da Saúde, Universidade Federal do Recôncavo da Bahia,
Avenida Carlos Amaral, 1015. Cajueiro CEP 44574-490. Santo Antônio de Jesus, Bahia, Brazil. E-mail: ana_amor@ufrb.edu.br

Received for publication: 15/6/2019. Reviewed: 16/7/2019. Accepted: 15/1/2020.

Rev Patol Trop Vol. 48 (4): 197-210. oct.-dec. 2019 197

the highest occurrence in humans are ascaridiosis (Ascaris lumbricoides),
enterobiosis (Enterobius vermicularis), hookworm (Ancylostoma duodenale,
Necator americanus) and Strongyloides stercoralis infection; while the
protozooses are: giardiasis (Giardia intestinalis) and amebiasis (Entamoeba
histolytica).
Globally, approximately 300 million people suffer from severe
morbidity, resulting in 10 000–135 000 deaths annually (WHO, 2012).
Helminths occur in areas where the socioeconomic level is low, especially
where there is no basic sanitation or this is precarious, causing transmissions,
depending on the parasite type, through contact with soil, hands and utensils,
or by eating food contaminated by eggs or larvae, as well as skin penetration of
hookworm and/or Strongyloides infective larvae (WHO, 2011).
In spite of technological advances, the reduction in the prevalence of
parasitic diseases has been insignificant in several localities, a fact that worries
health professionals worldwide, not only regarding the problems caused by
these diseases themselves, but also due to other resulting diseases, such as
anemia, malnutrition, intestinal obstruction, bleeding, neurological problems,
among others. These jeopardize the clinical status of the individuals, since the
asymptomatic diseases not previously diagnosed can become parasitic agent
disseminators (Fernandes, 2014).
Infections may happen due to precarious hygiene, health and basic
sanitation conditions, related to socioeconomic factors in certain populations,
as well as environmental factors such as no sewage systems, personal and
household waste thrown away in open spaces, garbage accumulation, lack
of domestic hygiene and continued coexistence with insects and parasitized
animals. The referred conditions cause children to become infected by
enteroparasites from contact with contaminated environments and objects,
reinforcing the epidemiological triad of the infection between the agent, the
environment and the host. The agent is the essential factor for the occurrence
of the disease; the host is the organism capable of becoming infected by an
agent, and the environment is the set of factors that interact with the agent and
the host (Belo et al., 2012).
In Brazil, the rate of infection by parasitic diseases is still high. It is
estimated that 12% of children from underdeveloped countries present this
type of infection, which may harm their cognitive function as well as influence
their nutritional status and, consequently, their normal growth (Vieira &
Amarante, 2011).
Cabral-Miranda et al. (2010) found a very high percentage of
enteroparasites in children and teenagers in the quilombola community of
Tijuaçu (Senhor do Bonfim-Bahia-Brazil), with high prevalence of Entamoeba
coli and Giardia intestinalis, and risk of infection by pathogenic parasites due
to living conditions with inadequate or no basic sanitation. The relationship
between household income and sanitary sewage showed that most individuals

198 Rev Patol Trop Vol. 48 (4): 197-210. oct.-dec. 2019

(68.4%) earned less than the minimum wage and that those who had treated
water at home presented lower incidence of infections, demonstrating a direct
association between socioeconomic and demographic aspects regarding
enteroparasite infections.
Considering that the socioeconomic, cultural and environmental
conditions of a population can influence the development of infections caused
by enteroparasites, this study was carried out to investigate the prevalence of
intestinal parasites and the socioeconomic and cultural profile of individuals
living in the rural area of Santo Antônio de Jesus, Brazil.

MATERIAL AND METHODS

Study design

The study was carried out from July to October 2015 with 53 families
from Rio do Onha and Riacho Dantas, a rural area in the municipality of Santo
Antônio de Jesus-Bahia-Brazil, totaling 154 participants. The families were all
next door neighbors and their respective residences were located very close to
each other when viewed from the street. A sample per person was analyzed in
each family. The 53 families surveyed lived in all the 53 occupied houses in
the researched area (100%) during the period of study, where rural labor was
the main activity performed by these families’ breadwinners.
Participating adults and those responsible for the local child and
teenage population answered a semi-structured questionnaire for the collection
of socioeconomic, demographic, clinical and cultural data, after signing the
informed consent form. In addition, there was a free and informed consent form
signed by the over five minors themselves. This research was authorized by the
Human Research Ethics Committee at the Federal University of Recôncavo da
Bahia (UFRB) (CAAE: 40542314.5.0000.0056).

Laboratory analysis

The following were utilized for the parasitological diagnosis (helminths

and intestinal protozoa): Qualitative coproscopic methods of Hoffmann, Pons
and Janer (spontaneous sedimentation); Baermann-Moraes and adhesive tape
(Graham) as well as Kato-Katz quantitative, performed at the Parasitology
Laboratory in the Food and Nutrition Security Nucleus of the Center of
Health Sciences/UFRB. On the day of the visit, identified plastic containers
and a glass slide with adhesive tape and instructions were handed out for
the parasitological exams of feces (one container per individual) and for the
Graham adhesive tape technique.

Rev Patol Trop Vol. 48 (4): 197-210. oct.-dec. 2019 199

 Considering the receipt of only one sample per resident, more than one
method was used to increase the possibility of finding parasitic forms in the
analyzed samples, as well as the possibility of quantifying the parasitic load in
the studied individuals, increasing the diagnostic accuracy.
The Hoffman, Pons and Janer method, also known as spontaneous
water sedimentation method, is a qualitative test to identify helminth eggs and
larvae as well as protozoan cysts (with less sensitivity to the latter pathogens),
by gravitational sedimentation of these organisms. It is considered a simple,
economical and practical exam, with the disadvantage of the visualization
time being of at least 2 hours, when ideally there should be 24 hours between
the sediment washings. The advantage consists in its low cost and wide
spectrum of use, frequently the only technique adopted in laboratories with
few resources. The Kato Katz technique was used in this study as it allows
the identification and quantification of some helminth eggs per gram of feces
by means of a card with a central hole 6 mm in diameter, defining the amount
of feces to be examined per sample. Made-up slides may be transported and
stored at room temperature for months, without impairing results. In order to
find helminth larvae, Baermann’s method of larval concentration was utilized,
based on the positive thermo hydrotropism of these larvae. Graham’s method,
consisting of the use of a piece of transparent gummed tape, adapted to a glass
microscopy slide, facilitates, for instance, access to the perianal region for
collecting Enterobius vermicularis or Taenia sp eggs, (De Carli, 2011).

Statistic data

The data were tabulated and analyzed in the SPSS STATISTICS

16.0 version program, elaborating categories and establishing the analytical
description of the data, considering statistical significance using the Pearson
chi-square test with p value <0.05.

RESULTS

A total of 154 semi-structured questionnaire samples were applied

resulting in 144 (93,5%) stool samples.
In relation to the coproparasitological analysis, the high frequency
of hookworm encountered in the feces of the studied population stands out.
The following parasites were found: Endolimax nana (63.9%), Entamoeba
coli (29.9%), Giardia intestinalis (27.1%), Entamoeba histolytica/E. dispar
complex (16%), Iodamoeba butschlii (2.1%); hookworms (47,9%), Enterobius
vermicularis (10.4%), Ascaris lumbricoides (9.7%), Trichuris trichiura (5.5%),
Trichostrongylus sp. (2.1%), Schistosoma mansoni (2.1%), Strongyloides
stercoralis (1.4%) and Taenia sp. (2.8%).

200 Rev Patol Trop Vol. 48 (4): 197-210. oct.-dec. 2019

 The panorama of the species by method (Figure 1) suggests the classic
spontaneous sedimentation (in common collector and processing for 24 hours)
as an adequate method for identifying most of the parasitic forms. The Graham
method with the greatest sensitivity for finding Enterobius vermicularis eggs
and the Kato-katz method showed a slight quantification in the individuals
studied (for the hookworm, Trichuris trichiura, Enterobius vermicularis,
Schistosoma mansoni and Ascaris lumbricoides parasites).

Figure 1. Panorama of the parasites found by parasitological method -

Population of the rural area of Santo Antônio de Jesus-Bahia, 2015.

Figures 2A and 2B present the laboratory analysis data. In 2A, the

highest prevalence of infection by intestinal protozoa was observed, with
an approximate percentage of 35% (n = 50). In 2B, the category (degree) of
parasitism accentuates a higher prevalence for infection by more than one
parasite [biparasitic plus polyparasitic individuals, totaled 48% (n = 69) of the
samples].

Figure 2. Feces parasitological exam results: (A) per group of parasites; (B) by
category of parasitism-Santo Antônio de Jesus-Bahia, 2015.

Rev Patol Trop Vol. 48 (4): 197-210. oct.-dec. 2019 201

 The lower the monthly household income of the families surveyed, the
greater the occurrence of parasites associated with bi- and/or polyparasitism
(Figure 3A). The data presented predominantly the gender / female gender
with a higher percentage of positivity for some enteroparasites (53.7%), with
emphasis on bi- and polyparasitism (Figure 3B).

Figure 3. Profile of parasitism level: (A) with family income; (B) with the
gender / gender of the research participants-Santo Antônio de Jesus, 2015.

The age brackets from 5 to 8 and from 38 to 43 years of age presented

a higher prevalence of positive fecal samples, 12.0% and 9.3%, respectively.
The total number of teenagers from 14 to 18 years of age and of the elderly
over 81 years of age were 100% parasitized (Table 1). Statistical significance
was observed with a p value <0.05 regarding positivity for enteroparasites
among the age groups surveyed by Pearson’s chi-square test.

202 Rev Patol Trop Vol. 48 (4): 197-210. oct.-dec. 2019

 Table 1. Age distribution of participants, level of education, marital status and labor data of adults correlated with positive for
enteroparasites - Rural area of Santo Antônio de Jesus, 2015.
Variables Parasitological Examination of Stool Variables Parasitological Examination of Stool
Positive Negative Total P value Positive Negative Total P value
(n=108;75%) (n=36; 25%)
n % n % n % % % %
Age group (years) < 0.05 Schooling for those over 18 years of age < 0.05
0≥x<1 2 1.85 3 8.33 5 3.47 None 24 16.36 18.75
1≥x<5 5 4.6 3 8.33 8 5.56 Incomplete basic 48 60 56.25
5≥x<8 13 12.04 1 2.78 14 9.72 Complete basic 8 0 2.5
8 ≥ x < 11 5 4.63 2 5.56 7 4.86 Incomplete Middle 12 18.18 16.25

Rev Patol Trop Vol. 48 (4): 197-210. oct.-dec. 2019

11 ≥ x < 14 7 6.48 1 2.78 8 5.56 Complete Middle 8 3.64 5
14 ≥ x < 17 3 2.78 0 0 3 2.08 Incomplete higher education 0 1.82 1.25
17 ≥ x < 18 4 3.7 0 0 4 2.78
18 ≥ x < 23 5 4.63 1 2.78 6 4.17 Marital status for those over 18 years old >0.05
23 ≥ x < 28 4 3.7 6 16.67 10 6.94 Not married 34.62 40 38.27
28 ≥ x < 33 7 6.48 3 8.33 10 6.94 Married 38.46 38.18 38.27
33 ≥ x < 38 9 8.33 1 2.78 10 6.94 Divorced 0 3.64 2.48
38 ≥ x < 43 10 9.26 3 8.33 13 9.03 Widowed 15.38 1.82 6.17
43 ≥ x < 48 8 7.41 4 11.11 12 8.33 Stable union 11.54 16.36 14.81
48 ≥ x < 53 5 4.63 2 5.56 7 4.86
53 ≥ x < 58 3 2.78 3 8.33 6 4.17 Labor data for those over 18 years of age >0.05
58 ≥ x < 61 1 0.93 1 2.78 2 1.39 Works with a formal contract 7.69 5.36 6.1
61 ≥ x < 71 9 8.33 1 2.78 10 6.94 Works without a signed handbook 42.31 44.64 43.9
71 ≥ x < 81 4 3.78 1 2.78 5 3.47 Receive research grant or similar 0 3.57 2.44
81 ≥ x < 91 1 0.93 0 0 1 0.69 Other 34.62 21.43 25.61
91 ≥ x < 101 1 0.93 0 0 1 0.69 Received government benefit 15.38 25 21.95
≥ 101 2 1.85 0 0 2 1.39 Source: Authors’ data.

203
 The parasites were widely distributed among the studied age groups.
It is worth noting that from 14 to 18 years, the parasites were: Entamoeba
coli, Entamoeba histolytica / E. dispar complex, Endolimax nana, Giardia
intestinalis, Ascaris lumbricoides, hookworms, Trichuris trichiura, Enterobius
vermicularis. For the age group above 81 years, the identified parasite was
Endolimax nana (non-pathogenic, but indicative of oral-fecal contamination).
Considering positivity in the age group between 0 and 1 year of age, the
parasites found were: Giardia duodenalis, Ascaris lumbricoides, Enterobius
vermicularis and Endolimax nana.
Regarding adult education, most of the interviewed people do not
present complete basic education. The only individual with incomplete higher
education did not present positivity in the analyzed sample (Table 1). Statistical
significance was observed with p <0.05 for positivity for enteroparasites among
the studied schools, based on Pearson’s chi-square test.
The largest portion of the adult population in the communities
surveyed, considering the total percentages, consisted of married individuals
within a stable union, also presenting higher frequencies for positivity to
enteroparasites. It is noteworthy that 80% of the declared widows were
parasitized (Table 1).
Most individuals worked without a formal labor contract. In regard
to this variable, higher percentages were verified for the individuals with a
negative sample for each category of the item. Data were not statistically
significant (Table 1).
In the studied population, the highest percentages of individuals had
undergone a feces parasitological evaluation one year or 6 months to more than
a year before the moment of the interview for this study (Table 2).
Data were not statistically significant. Individuals who reported not
having had a stool parasitology test less than 6 months previously or who had
never had one or did not know how long it was since the last one stood out
regarding polyparasitism.
Regarding positive result for helminths or protozoa on a previous
feces parasitological examination, we highlight those who answered negatively
to this question and presented positivity to enteroparasites in this study (Table
2). Data were not statistically significant (p> 0.05).
Even those who reported having used helminth or protozoan drugs in
the last 12 months presented samples with positive results for enteroparasites
and polyparasitism (Table 2).

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Table 2. Data on parasitological exams and use of drugs correlated with positive
for enteroparasites-Rural area of Santo Antônio de Jesus, 2015.
Variables Parasitological Stool Examination Total P value
Monoparasitism Biparasitism Polyparasitism Not infected
n n n n
Time elapsed since the last parasitological feces examination >0.05
Under 6
7 2 3 6 18
months
From 6 to
8 8 11 9 36
12 months
More than
17 17 16 16 66
12 months
Never done 3 1 5 3 12
Do not
4 2 4 2 12
know
Total 39 30 39 36 144

Have had positive parasitological stool examination for helminths or intestinal

>0.05
protozoa
Yes 5 10 10 9 34
No 25 14 19 21 79
Not
2 1 3 3 9
applicable
Do not
7 5 7 3 22
know
Total 39 30 39 36 144

Have you taken any medicine for helminths or intestinal protozoa in the past twelve
>0.05
months
Yes 14 9 11 19 53
No 23 21 25 17 86
Do not
2 0 3 0 5
know
Total 39 30 39 36 144
Source: Authors’ data.

DISCUSSION

Data on the identification of parasitic contamination in peridomiciliary

soil, enteroparasite infection in humans and domestic animals in Riacho Dantas
and Rio do Onha, rural community of Santo Antônio of Jesus (Bahia, Brazil)
can be found in Andrade et al. (2018). Another view of this study generated the
results presented in this paper.
The enteroparasites found in the studied population, whether pathogenic
or commensal, and the association with socioeconomic, demographic and
Rev Patol Trop Vol. 48 (4): 197-210. oct.-dec. 2019 205
cultural aspects, suggest a contamination cycle in the environment, mainly due
to lack of basic sanitation. These data persist in a large number of municipalities
in Bahia (Cabral-Miranda et al., 2010; Seixas et al., 2011; Oliveira & Amor,
2012; Carvalho et al., 2016).
The variable on adult educational level presented a higher prevalence
of enteroparasite infections for those with incomplete elementary education,
with statistical significance, which may be linked to ignorance regarding
personal hygiene and / or food hygiene, a factor of extreme importance for
the persistence of infection by enteroparasites. Since the highest percentage
of positive fecal samples were found in adults with this level of education,
the possibility of compromising the individual and the collective as well
as association with care for the young population is explicit. Mascarini &
Donalísio (2006) demonstrated a significant influence of maternal schooling
and environmental quality, indicating that mothers with better schooling have
more access to information on child development and can provide a better
physical and emotional environment for the development of their children.
Intestinal parasitic diseases are observed more frequently in the lower
social classes which present lower levels of schooling, and decrease gradually
in the economically privileged classes with better levels of educational
(Vasconcelos et al., 2011). The monthly income prevalent in the population
in this study seems to be associated with higher positivity for enteroparasites.
Public agencies should establish public policies focusing on the
reduction of parasitic infections, especially those actions focusing on health
education plans in order to raise public awareness regarding hygiene and
diseases caused by enteroparasites. Investments in areas such as health and
infrastructure are also necessary (Fernandes, 2014). It is known that sanitary
precariousness confirms socio-environmental inequality, which affects quality
of life and harms human dignity (Maia et al., 2014).
The present study shows a general prevalence of 75% of the individuals
parasitized by at least one parasite, a relatively high value when compared
to other studies and with a higher prevalence of intestinal parasitism in the
child and teenager population. The data corroborates the study carried out by
Oliveira & Amor (2012) in the city of Araci-Bahia, Brazil.
Infection by enteroparasites should be observed from the first years
of life, which complements the study by Busato et al. (2014), in which
children presented risk of infection by intestinal parasites in Chapecó (Santa
Catarina, Brazil). Therefore, those that often play barefoot, in soil that may be
contaminated, in addition to the habit of placing their hands and objects in their
mouths, are particularly vulnerable to infection by enteroparasites.
The two parasitized children under 1 year of age were positive for
Giardia intestinalis, Ascaris lumbricoides, Enterobius vermicularis and
Endolimax nana, enhancing how the environment can jeopardize the physical

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and intellectual growth of these children, due to the cycle of infection and re-
infection to which they will be submitted.
The presence of Enterobius vermicularis, is outstanding in stool
samples from members of different families.
It is important to note that the elderly population, over 81 years of age,
also presented parasitism with 100% positivity for a non-pathogenic parasite
- Endolimax nana - which evidences the fecal-oral contamination in this
population. Coproparasitological surveys should be carried out with the adult
population, mainly with the elderly group, identifying their particularities,
with the objective of proposing sanitary and educational measures to improve
the health status of the population in general. The elderly group is considered
vulnerable to parasitic diseases for many reasons such as the unfavorable
environmental conditions and the progressive loss of autonomy regarding self-
care with frequently inadequate personal and food hygiene, often dependent
on caregivers who are not always prepared for this function (Matos & Murai,
2005).
The prevailing marital status was that of married individuals reportedly
coexisting in stable unions. This group also presented higher percentages
of enteroparasites in the samples analyzed. Considering the possibility of a
family cycle, it is important to increase knowledge on personal and/or food
hygiene, as well as the destination of residues and care with the presence of
domestic animals which can serve as vectors for parasite dissemination and
environmental contamination (Vieira & Benetton, 2013).
Another factor to be considered is that most of the infected individuals
are engaged in informal work, without a formal contract, and since it is a
rural environment, many of them work as farmers, in activities with the soil
which is contaminated daily with fecal waste, facilitating the infection of these
individuals. The previous analysis of the soil in the surveyed communities
showed that it presents great contaminating potential, with the concomitance
of protozoa and helminth nematodes, as well as some of the soil biota and other
elements pathogenic to humans and/or their domiciled animals (Fonsêca et al.,
2015).
The number of infected individuals who were polyparasited was
higher than that found by Belo et al. (2012) in the city of São João del-Rei,
Minas Gerais (Brazil), in which he discusses the controversy of the situation
as high levels were expected since polyparasitism has been considered a norm
rather than an exception. These data show the need to better investigate the
impacts and occurrences that may be caused by polyparasitism in humans and
the factors that predispose this occurrence to the particular community.
The data show that, even for individuals who reported the use of
antiparasitic drugs for helminths and protozoa, positive samples were found for
some of these enteroparasites or for both, indicating that curative medication
is only punctual, requiring the onset of a more preventive practice, the result

Rev Patol Trop Vol. 48 (4): 197-210. oct.-dec. 2019 207

of health education in conjunction with environmental modifications and the
implementation of adequate sanitation.
The distribution of drugs to combat parasitic infection has been
increasing over recent years in Brazil (Martins et al., 2014), where the
prescription of broad-spectrum drugs has been a recurrent practice by
physicians to combat parasitic diseases, especially in children, even without
any classic symptoms. However, it is believed that without constant preventive
measures and/or the establishment of infrastructure that avoids contact between
the parasite and the host, cycles of infection and reinfection will continue to
occur in these environments.
The inadequacy noted in studies of this type lies in the fact that not
all the population researched received preventive return treatment according
to the different degrees of prophylaxis, whether first degree or prevention,
so that the infection does not occur by one of the parasites; for the second
degree to combat parasitosis; and the third degree, to minimize damage
already caused by the action of the parasite. In addition, there are not enough
studies aimed at implementing measures that are relevant and essential to the
community because many places are still deficient regarding basic sanitation
and information on the correct way to perform personal and food hygiene
(important mechanisms of infection for enteroparasites when inadequate).
Therefore, it is necessary to monitor the health conditions of the population,
especially children and teenagers, both those living in rural areas (countryside)
and those living in urban environments (capitals) which present poor sanitary
conditions in this country.
In order to better understand the specific demands related to health
research in Brazil, defining priorities is a difficult task. In this way, it is hard
to perform a survey of the country’s epidemiological profile, characterized
by persistent problems, including tropical and neglected diseases, emerging
epidemics and chronic non-communicable diseases, in localities where the
health investments needed are numerous and the resources to address them
are limited. Identifying these priorities is fundamental to maximize the use of
investments by directing public resources responsibly to meet the needs of the
population (Brasil, 2018).
Ideally, the results of this study will help to prevent as well as solve
public health problems, improve the quality of care and contribute to the
implementation of more effective public health policies.
The prevalence of parasitic infections in the locality studied in Santo
Antônio de Jesus, Bahia is still very high, especially in children and teenagers.
In this context, it is necessary to develop knowledge-building activities
regarding personal hygiene, domestic, environmental, and food hygiene
associated with the implementation of basic sanitation by the authorities, since
these are the factors that interfere directly in the contamination and infection
of the comunity.

208 Rev Patol Trop Vol. 48 (4): 197-210. oct.-dec. 2019

 Most of the analyzed individuals were bi- and/or polyparasitized, and
this result is associated with schooling, marital status and the type of work
performed by the breadwinners, probably unable to actively contribute to the
socio-educational training of the children and/or teenagers leading to their
insufficient basic hygiene practices.
Further studies related to polyparasitism, its causes, factors and possible
consequences in nutritional status and cognitive development, especially in
children, are required, as well as the need for in depth understanding of risk
factors correlated to geohelminths, in an attempt to improve the effectiveness
of preventive and control measures regarding intestinal parasites.

ACKNOWLEDGEMENTS

The authors would like to thank the Community of Onha and Riacho Dantas
who participated in this study and the Center of Health Sciences/Federal University of
Recôncavo of Bahia (CCS/UFRB) for transportation in field activities, as well as the
Coordination of Improvement of Higher Education Personnel and the National Council
of Scientific and Technological Development for assistance to fellows in the Young
Talents Program for Science and in the Institutional Program for Scientific Initiation
Grants-2015/2016, respectively.

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